Healthcare Provider Details

I. General information

NPI: 1932751211
Provider Name (Legal Business Name): PATRICIA M MILFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 WRIGHT AVE
CROWLEY LA
70526-2226
US

IV. Provider business mailing address

1325 WRIGHT AVE
CROWLEY LA
70526-2226
US

V. Phone/Fax

Practice location:
  • Phone: 337-788-2014
  • Fax:
Mailing address:
  • Phone: 337-788-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number857070
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP142282
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP142282
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number210942
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: